{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T19:12:49Z","timestamp":1772219569608,"version":"3.50.1"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Kunshan Development Zone Medical and Health Science and Technology Innovation Project","award":["X23-189-101591"],"award-info":[{"award-number":["X23-189-101591"]}]},{"name":"Special Project for Social Development Science and Technology of Kunshan City","award":["X24-038-101326"],"award-info":[{"award-number":["X24-038-101326"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Red blood cell volume distribution width (RDW) and albumin have been increasingly recognized for their roles in inflammatory diseases. However, the relationship between RDW-to-albumin ratio (RAR) and acute kidney injury (AKI) in acute pancreatitis (AP) patients has not been clarified. Therefore, the research aims to explore the correlation between RAR and AKI risk in critically ill patients with AP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients diagnosed with AP from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database were included in this retrospective study. The primary outcome measure was the incidence of AKI. Logistic regression analysis and restricted cubic spline were used to evaluate the relationship between RAR and AKI incidence in AP patients. Subgroup analyses were used to test interactions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 600 patients were enrolled in the study. The incidence of AKI was 77.3%. Based on multiple logistic regression analysis, RAR exhibited a positive association with AKI incidence as either a continuous (OR 1.46, 95% CI 1.22\u20131.76, P\u2009&lt;\u20090.05) or categorical variable (OR 2.79, 95% CI 1.69\u20134.59, P\u2009&lt;\u20090.05). The restricted cubic splines model illustrated the linear relationship between higher RAR and increased risk of AKI in AP patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High RAR is an independent risk factor for AKI in critically ill patients with AP. Early assessment of RAR may facilitate risk stratification to guide clinical management, thereby improving clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0341471","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T18:25:37Z","timestamp":1772216737000},"page":"e0341471","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictive value of red cell distribution width to albumin ratio for acute kidney injury in patients with acute pancreatitis"],"prefix":"10.1371","volume":"21","author":[{"given":"Jin","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Peng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1879-2475","authenticated-orcid":true,"given":"Chenyang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"issue":"9988","key":"pone.0341471.ref001","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/S0140-6736(14)60649-8","article-title":"Acute pancreatitis","volume":"386","author":"PG Lankisch","year":"2015","journal-title":"Lancet"},{"key":"pone.0341471.ref002","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1053\/j.gastro.2018.08.063","article-title":"Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: Update 2018","volume":"156","author":"AF Peery","year":"2019","journal-title":"Gastroenterology"},{"issue":"4","key":"pone.0341471.ref003","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1159\/000337487","article-title":"Acute kidney injury and mortality in hospitalized patients","volume":"35","author":"HE Wang","year":"2012","journal-title":"Am J Nephrol"},{"issue":"3","key":"pone.0341471.ref004","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s12664-016-0647-y","article-title":"Pathophysiological mechanisms in acute pancreatitis: Current understanding","volume":"35","author":"P Singh","year":"2016","journal-title":"Indian J Gastroenterol"},{"issue":"7","key":"pone.0341471.ref005","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.2215\/CJN.13191118","article-title":"AKI associated with acute pancreatitis","volume":"14","author":"TI Nassar","year":"2019","journal-title":"Clin J Am Soc Nephrol"},{"key":"pone.0341471.ref006","doi-asserted-by":"crossref","first-page":"116690","DOI":"10.1016\/j.biopha.2024.116690","article-title":"The role of mitochondrial damage-associated molecular patterns in acute pancreatitis","volume":"175","author":"Y Zhou","year":"2024","journal-title":"Biomed Pharmacother"},{"key":"pone.0341471.ref007","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1055\/a-1255-3413","article-title":"[Acute kidney injury following acute pancreatitis (AP-AKI): Definition, Pathophysiology, Diagnosis and Therapy]","volume":"58","author":"FG Scurt","year":"2020","journal-title":"Z Gastroenterol"},{"key":"pone.0341471.ref008","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1186\/s13054-015-1149-5","article-title":"Long-term remote organ consequences following acute kidney injury","volume":"19","author":"C-C Shiao","year":"2015","journal-title":"Crit Care"},{"issue":"9","key":"pone.0341471.ref009","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1515\/cclm-2014-0585","article-title":"Red blood cell distribution width (RDW) and human pathology. 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